连翘 瞿麦穗 滑石 车前子 牛蒡子(炒) 红芍药(各一两) 山栀 木通 川当
归防风(各半两) 黄芩(去心一两半) 柴胡(去芦) 甘草(炙各二两) 荆芥穗(一两半)
蝉蜕(去大脚一两)
上件一十五味 咀每服一大两水小小盏汤使在前
议曰此方解利心经邪热心与小肠受盛小肠乃水窦常宜通利壅则结滑则脱热则涩盛则淋平
凉心经三焦自顺不待疾作而解症成而疗者疏怠
有之矣一十五味加汤使在前才觉蕴热客热寒
邪风邪胃入肺经心将受之心不受触传于小肠或闭或涩或
赤或白淋沥不通荣卫不顺壅之作疾其发多端以至鬲热眼目膻赤唇口白疮津液不生涕唾稠盛虽
在表里俱得其宜惊风悉能散化痰热亦自消除连翘之功不虚设尔
青篙(取花头用童子小便浸一二次日干为度) 柴胡(去芦) 人参 黄芩(去心) 前胡
秦艽(去土) 甘草(炙)
上木分 咀每服一岁儿半两两岁一两匕水小小盏入生藕生梨(梨条亦得)薄荷二叶生地黄
一寸同煎至半去滓通口空心食前服两滓并煎作一服
议曰此方治脾积寒热其状如疟乃由脾气阴阳相胜故也其寒在先阴胜于阳其热在后阳胜阴
阴阳循之经络传归于本根据前复作不越三日而止重则头痛呕逆久则二三岁不歇左胁有块
小者如桃李大者似坏堞治法下去症积痞块自
消然寒热亦
未能自解宜先与服梨浆饮连滓并三服定去寒热了方可下积问之药性寒凉何以御之答曰所谓先
寒后热犹阴阳胜伏遁相更变阴积阳亏逆之致反故寒极热生热极阴作反汗自汗表有少解气聚复
作气虚愈重所服梨浆饮以毒攻毒药用青蒿以寒御寒其热不有寒必无加自然药与卫阴与阳合寒
热再潮未之有也和梨浆之功妙哉绝伦稍能知用无不得安若患三载不过两服曾经十年只以此方
妙用至纯使人钦叹而已
连翘、瞿麦穗、滑石、车前子、牛蒡子(炒制)、红芍药(各一两)、山栀、木通、川当归、防风(各半两)、黄芩(去心,一两半)、柴胡(去芦头)、甘草(炙制,各二两)、荆芥穗(一两半)、蝉蜕(去大脚,一两)。
以上十五味药,切碎。每次服用一大两,用水一小盏煎煮,先煎好汤药备用。
医议认为:此方旨在疏解心经邪热。心与小肠互为表里,小肠是水液代谢的通道,应当保持通畅利泄。若壅滞则结聚,通畅则排泄,受热则涩滞,热盛则淋沥。平抑心经之热,三焦气机自然顺遂,不必等到疾病发作才解除,病症形成后才治疗,那是疏忽懈怠的表现。
上述十五味药加上煎服法,只要察觉体内有蕴积之热或外客之热,风寒邪气侵入肺经,心即将受累但尚未直接受触时,邪气传于小肠,导致小便或闭或涩,尿色或赤或白,淋沥不通,营卫之气不顺,壅滞而致病,其发病表现多种多样。甚至出现膈部发热、眼睛和胸部发红、嘴唇口腔生疮、津液不生、鼻涕唾液稠厚等症状。无论病在表或在里,此方均能适宜应对,惊风皆可疏散,痰热亦能消除,连翘的功效确实不虚设。
青蒿(取花头,用童子小便浸泡一两次,晒干为度)、柴胡(去芦头)、人参、黄芩(去心)、前胡、秦艽(去泥土)、甘草(炙制)。
以上七味药,切碎。每岁小儿服用半两,两岁小儿服用一两匕,用水一小盏,加入生藕、生梨(梨条也可以)、薄荷两片、生地黄一寸,共同煎煮至一半水量,去渣,空腹、食前温服。将两次药渣合并再煎一次作为一服。
医议认为:此方治疗脾积引起的寒热往来,症状类似疟疾,这是由于脾气阴阳相互胜负所致。寒象在先,是阴胜于阳;热象在后,是阳胜于阴。阴阳循行经络,传归于本脏,根据前证复发,不超过三天就会停止。病情重的会出现头痛、呕吐逆气;病程久的,两三岁都不曾停歇,左胁下有肿块,小的像桃李,大的似城墙女墙。治疗方法在于去除症积痞块,痞块自会消散。然而寒热症状也不能自行解除,应先给予服用梨浆饮,连同药渣一起分三次服用,待寒热定止后,方可使用攻下积滞的药物。有人问:药性寒凉,如何抵御病邪?回答是:所谓先寒后热,犹如阴阳胜伏交替变化,阴积阳亏,逆乱所致。反常情况下,寒极生热,热极生寒,反而出汗,体表稍有缓解,但气聚又发作,气虚更加严重。所服的梨浆饮,以毒攻毒,用药性之寒来抵御病邪之寒。如果热邪不除,必然不会加重,自然是药物与卫气相合,与阴气相合,寒热再次潮涌的情况是不会有的。梨浆饮的功效,妙绝绝伦,稍微懂得运用的人,没有不能痊愈的。如果患病三年,不过服用两剂;曾经患病十年,只靠此方的妙用,极其纯正,令人钦佩感叹罢了。
Forsythiae Fructus (Lianqiao), Epimedii Herba Spatholobi Caulis? No, Qumai (Spermacoce Herba), Talcum (Huashi), Plantaginis Semen (Cheqianzi), Arctii Fructus (Niubangzi) [stir-fried], Paeoniae Radix Rubra (Hong Shaoyao) (each 1 liang), Gardeniae Fructus (Shanzhi), Akebiae Caulis (Mutong), Angelicae Sinensis Radix (Chuan Danggui), Saposhnikoviae Radix (Fangfeng) (each 0.5 liang), Scutellariae Radix (Huangqin) [heart removed, 1.5 liang], Bupleuri Radix (Chaihu) [rhizome removed], Glycyrrhizae Radix et Rhizoma (Gancao) [roasted, each 2 liang], Schizonepetae Spica (Jingjie Sui) (1.5 liang), Bombyx Batryticatus (Chantui) [large legs removed, 1 liang].
The above fifteen ingredients are coarsely powdered. For each dose, take 1 da liang, decoct with one small cup of water, prepare the decoction in advance.
Discussion: This formula resolves and benefits Heart Meridian pathogenic heat. The Heart and Small Intestine are interior-exteriorly related; the Small Intestine is the "water channel" (shuidou) responsible for receiving and transforming fluids, and should always be kept patent and draining. Stagnation leads to accumulation; patency leads to discharge; heat leads to astringency; excess heat leads to strangury. Cooling the Heart Meridian ensures the smooth flow of the Sanjiao (Triple Burner). One need not wait for the disease to manifest to resolve it, nor treat after symptoms have formed; such delay is negligence.
With the fifteen ingredients and the aforementioned decoction method, as soon as one perceives internal accumulated heat or external invading heat, if wind-cold pathogens enter the Lung Meridian and the Heart is about to be affected but has not yet been directly touched, the pathogen transmits to the Small Intestine. This may cause urinary obstruction or astringency, urine color red or white, dribbling strangury without relief, and disharmony of Ying (Nutrient) and Wei (Defensive) Qi. Stagnation gives rise to disease with diverse manifestations, including diaphragmatic heat, redness of eyes and chest (danchi), sores on lips and mouth, absence of body fluids, and thick nasal discharge and saliva. Whether the pathology is in the exterior or interior, this formula is suitable; it can disperse convulsions and wind, and eliminate phlegm-heat. The efficacy of Forsythiae Fructus (Lianqiao) is indeed not in vain.
Artemisiae Annuae Herba (Qinghao) [use flower heads, soak in child's urine once or twice, dry until ready], Bupleuri Radix (Chaihu) [rhizome removed], Ginseng Radix et Rhizoma (Renshen), Scutellariae Radix (Huangqin) [heart removed], Peucedani Radix (Qianhu), Gentianae Macrophyllae Radix (Qinjiao) [soil removed], Glycyrrhizae Radix et Rhizoma (Gancao) [roasted].
The above seven ingredients are coarsely powdered. For infants aged one year, take half a liang; for two-year-olds, take one liang bi (spoonful). Decoct with one small cup of water, adding fresh lotus root, fresh pear (pear strips are also acceptable), two leaves of Mentha Haplocalyx (Bohe), and one cun of Rehmanniae Radix Recens (Sheng Dihuang). Decoct until the volume is reduced by half, strain, and drink warm on an empty stomach before meals. Combine the dregs from the first and second decoctions to make one final dose.
Discussion: This formula treats spleen accumulation causing alternating chills and fever, resembling malaria. This arises from the competitive struggle between Yin and Yang Qi of the Spleen. Chills appearing first indicate Yin exceeding Yang; fever appearing later indicates Yang exceeding Yin. Following the meridians, the transmission returns to the primary organ, recurring based on previous patterns, stopping within three days. In severe cases, headache and vomiting occur; in chronic cases lasting two to three years, there is no respite, and a mass appears in the left hypochondrium, small like plum or peach, large like a city wall parapet. The treatment method involves removing the accumulation and masses, which will then dissipate spontaneously. However, the alternating chills and fever cannot resolve themselves; one must first administer Pear Syrup Drink (Lijiang Yin), taking the dregs along with the liquid, divided into three doses. Only after the chills and fever are stabilized can one proceed to administer purgatives for the accumulation. Someone asks: The drug properties are cold and cool; how do they resist the pathogen? The answer is: The so-called "chills first, fever later" resembles the alternating victory and subjugation of Yin and Yang. Yin accumulation and Yang deficiency lead to reversal. Conversely, extreme cold generates heat, and extreme heat generates Yin, leading to spontaneous sweating and slight relief at the exterior, but Qi aggregation causes recurrence, worsening Qi deficiency. The administered Pear Syrup Drink uses toxicity to attack toxicity, employing cold drugs to counteract cold pathogens. If the heat is not present, it certainly will not worsen; naturally, the drug harmonizes with Wei Qi and combines with Yin Qi. It is unprecedented for chills and fever to surge again. The efficacy of Pear Syrup Drink is exquisite and unparalleled; those who understand its application will achieve recovery. Even if the illness has persisted for three years, two doses suffice; even if experienced for ten years, this formula's pure and subtle application inspires admiration.